Healthcare Provider Details

I. General information

NPI: 1477685758
Provider Name (Legal Business Name): MR. GEOFFREY E HAMMOND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8465 STATE RT 339
BARLOW OH
45712
US

IV. Provider business mailing address

6745 N STATE RT 669 NW
MCCONNELSVILLE OH
43756
US

V. Phone/Fax

Practice location:
  • Phone: 740-678-2384
  • Fax: 740-678-8696
Mailing address:
  • Phone: 740-962-6492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-09316
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: